Lessening of pain on intravenous injection of Propofol-Lipuro by fentanyl and lignocaine pretreatment

Khaled M.A. Abdelsalam
Anesthesia Department, Ain Shams University, Cairo, Egypt

Correspondence Address:
Khaled M.A. Abdelsalam
Abdulaziz Medical City, Riyadh, 11426, PO 22490, Saudi Arabia

Source of Support: None, Conflict of Interest: None

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DOI: 10.7123/01.ASJA.0000423115.28486.8f

Propofol-Lipuro 1% consists of long-chain triglycerides (LCT) and medium-chain triglycerides that have been reported to cause less injection pain than traditional long-chain triglycerides.

This double-blinded prospective controlled study was designed to assess the effect of 100 mcg fentanyl pretreatment with venous occlusion on pain on injection of Propofol-Lipuro in comparison with lignocaine premixing, pretreatment, or placebo.

In a randomized double-blind controlled trial, 120 patients were assigned to receive one of the following four options: group 1: pretreatment with 2 ml normal saline+18 ml Propofol-Lipuro premixed with 2 ml normal saline; group 2: pretreatment with 2 ml normal saline+18 ml Propofol-Lipuro premixed with 2 ml lignocaine 2%; group 3: pretreatment with 2 ml lignocaine 2%+Propofol-Lipuro premixed with 2 ml normal saline; and group 4: pretreatment with fentanyl 100 mcg/2 ml+Propofol-Lipuro premixed with 2 ml normal saline. Any associated pain or discomfort was categorized using a 4-point verbal rating scale.

Twenty-one patients in group 1, 15 patients in group 2, 13 patients in group 3, and only seven patients reported pain in group 4 (P<0.001). Fourteen patients complained of moderate to severe pain in group 1 (six moderate and eight severe) and four patients complained of moderate to severe pain in group 2 (three moderate and one severe). Six patients complained of moderate to severe pain in group 3 (four moderate and two severe), compared with three patients who had severe pain in the fentanyl pretreatment group. No complications related to the study medications or propofol were reported in any patient for the first 24-h perioperative time period.

Pretreatment with fentanyl incorporated into the anesthesia induction technique is a simple and effective way to alleviate pain during the injection of Propofol-Lipuro in addition to both premixing and pretreatment with lignocaine. All reduced the incidence and severity of pain on intravenous injection of Propofol-Lipuro with high statistical significance than placebo.